Lonely in a crowd

I visited a person with aphasia today. This lady had mild to moderate aphasia, but severe apraxia. She understands situations and simple sentences, but cannot say a word on her own. While I was there, the visiting nurse came with a translator. The nurse, translator, husband and sister all sat in the living room with the patient. They all talked to each other, but not one remark was made to the person with aphasia. Once or twice she tried to enter the conversation by vocalizing, but she was ignored. This family is very caring, a lovely family. They tell me, "She understands everything." The nurse is also a good person. It just showed how difficult it is to include someone in education, decision-making, even conversation, when that person doesn't speak. Language is so much a part of us that we cannot even imagine not having it. And when someone cannot speak, it is hard to remember that they can still think - and feel.